Spleen-preserving distal pancreatectomy performed laparoscopically.

The current literature contains little information about laparoscopic surgery for pancreatic disease. We performed spleen-preserving distal pancreatectomy on 7 cases during the period from 2005 to 2008 at our university hospital, including 2 laparoscopic operations. Case 2: A 54-year-old woman was found to have a hypoechoic 4 x 4 cm lesion in the tail of the pancreas, adjacent to and impinging on the spleen. On careful assessment we suspected a mucoid cystic tumor (MCT), and performed a laparoscopic spleen-preserving distal pancreatectomy. Blood loss was 380 g, and operating time was 310 min. Case 1: A 27-year-old woman was found to have a hypoechoic 2 x 2 cm mass on ultrasound examination of the body of the pancreas. We performed laparoscopic spleen-preserving distal pancreatectomy for solid pseudopapillary tumour (SPT) of the pancreas. Blood loss was minimal, and operating time was 182 min. The other 5 cases were operated upon using the open method. All were female, with an average age of 54.8 years. The average blood loss was 387 g. Operating time was 321 min. Laparoscopic pancreatic surgery is generally thought to be difficult owing to the need for lymph node resection, and because nerve plexus invasion occurs with malignant tumors such as pancreatic cancer. The present case series was reported to demonstrate the techniques that have evolved the safety of the operation and its future potential related to the minimally invasive nature of the surgery.